Massage Therapy Coding

ICD-9 Coding

"I need a list of ICD diagnosis codes for massage claims so that I can start billing health insurance for some massage therapy clients. I don't see anything on your site about this. Why not? Thank you."

Every diagnosis has a corresponding numeric ICD-9 diagnosis code. If you want to know what the number means, you can purchase ICD-9 coding books or look the diagnosis code up on the web.

The reason I have not written anything about ICD-9 diagnosis codes is because as massage therapists, it is beyond our scope of license to diagnose clients. If the client comes to us with a physical problem, he or she should already have seen a physician. The physician should have a diagnosis on file for this client. If the client does not have knowledge of the diagnosis, it is our job as massage therapists to call the attending physician to get this information.

We cannot attempt to choose a diagnosis code to put on the HCFA claim form to bill insurance. Usually, the doctor's staff is pretty good about giving medical information to massage therapists, especially if the client is seeing you due to the doctor's orders.

Some staff will give the information over the phone. Others will send a letter and some will either fax or mail copies of the client's medical records pertaining to the specific ailment. They realize that in order for the client's health insurance to pay us, we must have their ICD-9 diagnosis code. Massage therapy coding is the same that the doctor puts on his/her claim form for payment as far as the diagnosis code. Massage therapy does have its own CPT coding.

CPT Coding

In order for you to file a medical insurance claim for reimbursement with your client's medical insurance, you will need to be familiar with ICD-9 diagnostic coding and CPT (Current Procedural Terminology) coding. That is correct. Before filing medical insurance claims, the claims must be properly coded.

All claims require a diagnosis code and a CPT code or they will be pended or denied by the insurance company. Of course, as a massage therapist, you will not be diagnosing the client. The referring physician will provide the diagnosis for you, along with the types of service the physician would like for you to perform.

Each treatment you provide the client has a CPT code. These codes are the key to filing medical insurance. They determine the amount you will be paid for each service you render. The ones you will use most are as follows:

97010 for hot and cold packs

97018 for paraffin bath treatment (hot wax)

97124 for medical massage

97139 for unlisted modalities

97140 for manual therapy and for myofascial release

With 97139, be sure and submit a brief description of the service rendered to save time. If you do not, the insurance company will either pend or deny the claim until a description is submitted.

Massage therapy coding changes periodically so check for the most current CPT book or go online for the most updated codes.

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